Treating Underlying Trauma to Beat Addiction

Although many people are eager to address their addiction, Simpson points out that understanding the trauma will make treating the addiction much easier.

Trauma. The word seems to be everywhere now, with open discussion about trauma responses of veterans, first responders, abuse survivors and others. Although we hear about trauma often, few people actually understand what it is, and how trauma can play a huge role in addiction and recovery.

“The bottom line is that trauma is an event that changes how we look at world and makes us feel that the world cannot be safe,” explains Cliff Simpson, the clinical director at Maple Mountain Recovery, a trauma-informed addiction treatment center in Mapleton, Utah.

Unfortunately it can be hard to define exactly what a traumatic event is, because trauma responses are so individualized. Something that traumatizes one person might not affect someone else the same way.

“Trauma can happen to anybody and for any kind of reason,” Simpson says. It can be caused by an on-going event, like childhood sexual abuse or a one-time event like experiencing a terrorist attack. Trauma can also be caused by a series of events that would not be detrimental if they happened individually, but which can affect someone deeply if they all happen at once. An example of that would be if someone experienced a car accident, the loss of a job and a theft in quick succession.

Most people have a fairly straightforward view of the world. They believe that the world is generally safe and that good things happen to good people, while bad things happen to bad people. A traumatic event can shake those beliefs.

“Trauma changes our behaviors, attitudes and the way that we look at the world,” Simpson says. For example, if someone has always believed that bad things only happen to bad people, experiencing a negative event can call into question what they know about themselves.

“We must be a bad person because we’re having this bad thing happen to us,” Simpson explains.

In order to correct this, people who have experienced trauma often lie to themselves or change the details of the event so that things will once again make sense.

“We change the details of what happened so we can continue to keep the worldview that [the] world is a safe place to be, good things good people, etc,” says Simpson. A person who has lost a loved one might tell themselves that their family member is on vacation rather than dead. While this denial isn’t healthy, it is a coping mechanism that allows people to get through the day.

Maladaptive coping mechanisms, like denial or substance misuse, are common in cases of trauma, Simpson says.

“We look at the world and try like crazy to help ourselves deal with the fact that in our eyes, we’re either not a good person or the world isn’t a safe place,” he explains. “There are a myriad of behaviors, any kind of behaviors, that people use to try to change the way that they feel about the world.”

Trauma-informed care is about looking at those behaviors and understanding that they come from the desire to feel safe again. Rather than address the undesirable behavior, people with trauma and their care providers must first understand the event that caused the trauma and how it has impacted the patient’s life.

“You have to address the thinking first,” Simpson explains. “It’s about addressing where they are and moving them toward a place where they can challenge their beliefs that they’ve gained about the world. Then you can establish new thought patterns and behaviors to challenge the maladaptive behaviors.”

Although many people are eager to address their addiction, Simpson points out that understanding the trauma will make treating the addiction much easier.

“In trauma-informed care we address the trauma first, and then we are already addressing the addiction because the trauma is driving the addiction,” he says.

That’s something that Simpson understands personally. He experienced childhood trauma that led to him developing unhealthy drinking habits.

“If I ignored the underlying issue and just worked on drinking I was unable to keep the wolves at bay,” he says. “As I addressed the trauma and the issues and thinking patterns that come with that, I was able to realize that the addiction comes from the trauma.”

Oftentimes getting to that point takes time, which is why Maple Mountain Recovery is a 45-day program at minimum. Simpson says that he most often sees a breakthrough three weeks into a patient’s time at the recovery center.

“A lot of people hold their behaviors and behave as normally as they can until their defenses start to break down,” he says. “Then all of a sudden when these behaviors are being shown the patient is able to see this is what’s going on with them, and to really understand their struggle.”

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